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Aug 3, 2023

Reproductive Health

Birth Control

Yaz vs Slynd - How to Choose the Right Birth Control for You

How Do Hormonal Birth Control Pills Work?

Birth control pills prevent pregnancy by targeting specific phases of the menstrual cycle. They achieve this by introducing synthetic hormones into the body to maintain a consistent hormone level, thus preventing the hormonal fluctuations responsible for the cycle. The primary hormones used in birth control pills are synthetic estrogens and progesterone (progestin).

Progestin plays a significant role in birth control by thickening the cervical mucus, which hinders the movement of sperm into the uterus. It also prevents the hormonal changes that trigger ovulation, effectively blocking the release of eggs. While estrogen also contributes to preventing ovulation, its primary function is often considered to be maintaining a "normal" menstrual cycle.

Read about Types of Birth Control

How to Choose the Right Birth Control Pill

Choosing a birth control pill can be challenging due to the wide range of options available. Not only are there different types of pills, such as monophasic, biphasic, and progestin-only pills, but there are also numerous choices within each category. Two commonly compared pills are Yaz, a monophasic pill, and Slynd, a progestin-only pill. So, when faced with the decision of selecting a birth control pill, which one should you choose?

Yaz vs Slynd

Yaz and Slynd are both highly effective birth control pills with different hormone contents.

Yaz is a combination pill that contains two active ingredients, ethinyl estradiol and drospirenone. Ethinyl estradiol is a synthetic form of estrogen, while drospirenone is a progestin (synthetic progesterone). These hormones work together to prevent ovulation and alter the cervical mucus, making it difficult for sperm to reach the uterus.

Slynd, on the other hand, is a progestin-only pill (POP), also known as the "mini-pill." Its main ingredient is drospirenone, a progestin. Slynd primarily works by thickening the cervical mucus and thinning the lining of the uterus, inhibiting fertilization and implantation.

Read more about Combination Pills vs Progestin-Only Pills

Administration

Both pills come in a 28-day pill package.

Yaz

Yaz is taken daily for 24 days, followed by a 4-day break where placebo pills are taken. Active pills contain 0.02 mg ethinyl estradiol and 3 mg of drospirenone.

Slynd

Slynd is taken daily without any break between packs. Each pill contains 4 mg of drospirenone. This continuous dosing regimen simplifies the schedule, making it easier for individuals to comply with their pill regimen.

Indications

While both medications are used for pregnancy prevention, Yaz has two additional FDA-approved indications:

  • Treatment for premenstrual dysphoric disorder (PMDD): Yaz is approved to alleviate the symptoms of PMDD, a more severe form of premenstrual syndrome (PMS). It can help manage symptoms such as mood swings, bloating, and irritability.
  • Treatment of moderate acne: Yaz is also approved for the treatment of moderate acne in women aged 14 years and older. It can be beneficial in reducing acne breakouts and improving the overall appearance of the skin.

Who Can Not Take These Medications

Both Yaz and Slynd are generally safe for most individuals, but there are some considerations and contraindications to be aware of. The differences between the two medications are primarily due to the presence of estrogen in Yaz.

Avoid both Yaz and Slynd if you:

  • Are pregnant
  • Have breast cancer
  • Experience undiagnosed vaginal bleeding
  • Have adrenal disorders
  • Have active liver disease

Avoid Yaz specifically and consider using Slynd if you:

  • Are within 6 weeks of delivery
  • Smoke and are older than 35 years
  • Have uncontrolled high blood pressure or diabetes
  • Have a history of blood clot
  • Experience migraines with aura

Side Effects

Both Yaz and Slynd, like any medications, may have potential side effects. Due to the differences in hormone types and strengths between the two pills, the specific side effects can vary slightly. Here are the most common side effects associated with each contraceptive pill, listed in descending order of likelihood:

Yaz
  • Headache
  • Changes in menstrual periods (spotting, irregular periods)
  • Nausea
  • Breast pain or tenderness
  • Mood changes
Slynd
  • Acne
  • Abnormal menstrual bleeding (occurring outside of the expected "period" timeframe)
  • Headache
  • Breast pain or tenderness

Side effects of oral contraceptives are often worst during the initial three months of use. Beyond this period these symptoms generally improve significantly or may even resolve completely. Therefore, it is commonly recommended to continue using a specific contraceptive for at least three months before considering a switch due to side effects, unless the side effects are severe. This timeframe allows for the body to adjust to the medication, increasing the likelihood of symptom improvement over time.

Cost

Price is likely the biggest difference between these two medications. Many progestin-only birth control pills are costly, particularly those containing drospirenone rather than norethindrone. The average retail price of a single 28-day package of Slynd is $236. Price for Yaz averages aroundy $55 for the same 28-day supply. However, this may change based on your insurance and/or specific pharmacy.

Which One Should I Be On?

Yaz and Slynd are highly effective birth control pills. The choice depends on your own preferences, budget, and medical history. There are a number of things to consider, which are all outlined in this table.

Yaz
Combination Pill
Slynd
Progestin-only Pill (Minipill)
Indications Pregnancy prevention
Treatment for premenstrual dysphoric disorder
Treatment for acne in women ages 14 and up
Pregnancy prevention
Strength 28 tablets
24 active pills: 0.02 mg ethinyl estradiol/ 3 mg drospirenone
and 4 placebos
28 tablets
4 mg drospirenone
Effectiveness 91 to >99% effective 91 to >99% effective
How it works Prevents pregnancy by blocking ovulation and thickening cervical mucous with progestin and estrogen Prevents pregnancy by blocking ovulation and thickening cervical mucous with progestin and estrogen
Side effects Headache
Menstrual cycle changes (spotting, irregular periods)
Nausea
Breast pain/tenderness
Mood changes
Acne
Abnormal menstrual bleeding (not during the “period”)
Headache
Breast pain/tenderness
Avoid if you Are pregnancy
Have history of breast cancer
Experience undiagnosed vaginal bleeding
Have adrenal disorders
Have active liver disease
Are within 6 weeks of delivery
Are a smoker and older than 35 years
Have uncontrolled high blood pressure or diabetes
Have history of a blood clot
Have heart disease
Expereience migraines with aura
Are pregnancy
Have history of breast cancer
Experience undiagnosed vaginal bleeding
Have adrenal disorders
Have active liver disease
Ave. retail price $55 per 28-day pack $236 per 28-day pack
Prices mentioned in this article are based on average retail price at major box chain pharmacy in the U.S. as of May 30, 2023.

References:

  1. Contraindications to the OCP. The Royal Children’s Hospital Melbourne. (n.d.). Retrieved May 30, 2023, https://www.rch.org.au
  2. NHS. (2020, April 17). How effective is contraception at preventing pregnancy?. NHS choices. Retrieved May 30, 2023, https://www.nhs.uk
  3. 3. YAZ (drospirenone/ethinyl estradiol) – Access data FDA-Approved Drugs [Internet]. [amended 04/2012; accessed 05/2023].
  4. Slynd (drospirenone) – Access data FDA-Approved Drugs [Internet]. [amended 05/2019; accessed 05/2023].
  5. Slynd. GoodRx. (n.d.). Retrieved May 30, 2023, from https://www.goodrx.com
  6. Generic Yaz. GoodRx. (n.d.). Retrieved May 30, 2023, from https://www.goodrx.com

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